Pharmacies often undergo changes to their businesses and operations, primarily to adapt to the changing landscape of providing pharmacy services. These changes are the natural evolution of a business over time. However, in undergoing these... Read More
You may have heard the phrase "CMS investigation." Unlike a CMS audit, which is administrative in nature, a CMS investigation usually connotes a federal criminal investigation of suspected health care fraud. A CMS investigation will likely be... Read More
Frier Levitt has been on the front-line when it comes to defending and scrutinizing audits conducted by Pharmacy Benefit Managers (“PBMs”) of independent pharmacies. Throughout our challenges against PBMs, we have uncovered and reported... Read More
https://www.youtube.com/watch?v=GkpfL0wjvaY Frier Levitt co-founder Jonathan Levitt, Esq. and pharmacist attorney Dae Lee, Pharm.D., Esq., CPBS talk about PBMs. Plan Sponsors often get taken advantage of by PBMs and it is important that Plan... Read More
https://www.youtube.com/watch?v=RgWy4EZpWIY In a world where PBMs also operate their own in-house specialty pharmacies, the incentive to reduce competition has never been stronger. PBMs have used a variety of reasons to justify network termination,... Read More
The U.S. Attorney’s Office, Western District of Louisiana, recently announced that the owner and operator of the Monroe-based Specialty Drug Testing, LLC (“Specialty”) was indicted by a Federal grand jury for violating the Federal... Read More
On October 2, 2020, federal prosecutors in Massachusetts charged three individuals for their alleged role in a complex durable medical equipment (“DME”) marketing scheme. Of note, two of the three were also charged with criminal violations of... Read More
Frier Levitt has identified an alarming trend in government investigations of pharmacies whereby Office of Inspector General (“OIG”) and Drug Enforcement Administration (“DEA”) issue subpoenas simultaneously or almost at the same time. ... Read More
In a recent but aggressive trend, Elixir (formerly known as Envision Rx) has begun to issue payment and claim submission notices of suspension to pharmacies generally alleging that the pharmacies have engaged in or are engaging in activity or... Read More
As a result of the COVID-19 pandemic, many Pharmacy Benefit Managers (“PBMs”) had taken some form of action to help prioritize patient care including providing safe access to prescription drugs. Many of the flexibilities and changes in policy... Read More
